Note: Complex visits may be billed at a higher level of service and cost.

Office-Based Injections

Service

Billing (CPT) Code

The Everett Clinic Self-Pay Fee

Prompt Pay Incentive 15%

**Trigger Point Injection (3 or more muscles)

20553

$158.50

$134.73

**Trigger Point Injection (1-2 muscles)

20552

$136.75

$116.24

**Injection Large Joint

20610

$147.25

$125.17

Injectables (Billed Per Unit)

Service

Billing (CPT) Code

The Everett Clinic Self-Pay Fee

Prompt Pay Incentive 15%

¹Triamcinolone Acetonide (typically 4 units used)

J3301

$3.75

$3.19

¹Methylprednisone Acetate (typically 1 unit used)

J1030

$9.50

$8.08

Procedures

Service

Billing (CPT) Code

The Everett Clinic Self Pay Fee

Prompt Pay Incentive 15%

*Steroid Injection (lumbar or sacral, 1 vertebrae)

64483

$564.25

$479.62

*Steroid Injection (each additional vertabrae)

64484

$221.00

$187.85

*Injection (sacroiliac joint)

27096

$412.25

$350.42

*Injection (cervical or thoracic)

62320

$403.75

$343.19

*Diagnostic or Therapuetic Injection (lumbar or sacral, 1 vertebrae)

64493

$443.25

$376.77

*Diagnostic or Therapuetic Injection (each additional vertebrae)

64494

$218.25

$185.52

*Radiofrequency Ablation (1 joint)

64635

$1,086.00

$923.10

*Radiofrequency Ablation (each additional joint)

64636

$457.00

$388.45

Facility Fees

Service

Billing (CPT) Code

The Everett Clinic Self Pay Fee

Prompt Pay Incentive 15%

Steroid Injection (lumbar or sacral, 1 vertebrae)

64483.SG

$837.75

$712.09

Steroid Injection (each additional vertabrae)

64484.SG

$837.75

$712.09

Injection (sacroiliac joint)

27096.SG

$105.00

$89.25

Diagnostic or Therapuetic Injection (lumbar or sacral, 1 vertebrae)

64493.SG

$843.00

$716.55

Diagnostic or Therapuetic Injection (each additional vertebrae)

64494.SG

$837.75

$712.09

Radiofrequency Ablation (1 joint)

64635.SG

$2,016.00

$1,713.60

Radiofrequency Ablation (each additional joint)

64636.SG

$837.75

$712.09

Physical Therapy Services*

Service

Billing (CPT) Code

The Everett Clinic Self Pay Fee

Prompt Pay Incentive 15%

***Physical Therapy Evaluation (untimed code)

​97161-97163

$193.75

$164.69

***Physical Therapy Re-evaluation (untimed code)

97164

$131.75

$111.99

Therapeutic Exercise, 15 minutes each

97110

$77.75

$66.09

Therapeutic Activities, 15 minutes each

97530

$84.25

$71.62

Manual Therapy Techniques, 15 minutes each

97140

$72.00

$61.20

Neuromuscular Re-education, 1 or more areas, 15 minutes each

97112

$81.25

$69.07

Self-care/Home Management, 15 minutes each

97535

$84.50

$71.83

*Note: Most of the services in Phyiscal Therapy will be time-based. A 45-minute treatment will often result in three billable codes. The codes used will depend on the type of Physical Therapy you receive.

Behavioral Health Services

Service

Billing (CPT) Code

The Everett Clinic Self Pay Fee

Prompt Pay Incentive 15%

Psychotherapy, 45 minutes

90834

$201.00

$170.85

Psychiatric Diagnostic Evaluation

90791

$346.50

$294.53

*Indicates that one facility fee will be billed per procedure.

**Indicates that injection code is used in conjunction with applicable drug from injectables chart.

***Indicates that these evaluation codes are often billed in conjunction with other codes listed in this section.

¹ Indicates that an injectable or infusion drug price is per unit; multiple units may be administered.

Disclaimer: While The Everett Clinic strives to give you accurate information regarding prices and estimated costs, several factors may affect pricing, including, but not limited to: (1) Time of selection: Prices are subject to change at any time. (2) Additional expenses: Beyond what's defined, some laboratory and professional fees, such as physician, radiologist, anesthesiologist and pathologist, may not be included in this estimate. (3) Additional services: Your health condition may require additional time with the same practitioner, specialist or a different condition than scheduled.

Resources

What is Self-Pay?

If you are paying the bill yourself or services will not be processed by insurance.

What is Prompt Pay?

The deposit payment for your visit and any services paid by the first statement due date are eligible for a prompt pay savings incentive of 15% OFF.

Excluding cosmetic treatment and retail items.

What is CPT?

A CPT or Billing Code is a number you can use if you want to call your insurance company to validate your out of pocket expense.

Note: Complex visits may be billed at a higher level of service and cost.